As I watched President Obama sign the Family Smoking Prevention and Tobacco Control Act in the White House Rose Garden, I shared a deep feeling of pride with many public health champions on hand for the ceremony and hundreds of others who fought long and hard for this moment.
We share a profound sense of the impact this landmark public health law will have on our nation's health. The bill will prevent more than 2 million of our nation's young people alive today from starting to smoke, saving some 700,000 of them from premature deaths related to smoking.
I also see a roadmap for what prevention can do for health reform. As we grapple with the devil in the details, let's keep our eyes on the prize—helping all Americans lead healthier lives with a good quality of life.
Obama said, "Unless we fix what is broken in our current system, everyone's health care will be in jeopardy." I agree. The status quo is not an option. Coverage, improving the quality and value of care and driving down spending all must be part of comprehensive reform.
But a key aspect of our health care system that desperately needs fixing is finding a way to prevent illness and disease in the first place and not just treat or manage problems after their onset. To get true reform, we have to put community health directly into the health reform recipe. That means getting right down to where we live, work, learn and play, including policies that help us make healthier choices. And that is what is so groundbreaking about the new law giving the U.S. Food and Drug Administration (FDA) authority over tobacco.
The new law cracks down on sales and marketing of cigarettes to kids, including in the magazines kids read, in the stores they frequent and near their schools and playgrounds. It will require bigger, bolder health warnings on tobacco products and put a stop to deceptive health claims about tobacco products aimed at discouraging smokers from quitting.
As bold and hard-hitting as the new law is, it is only part of the picture in the campaign to reduce tobacco use. Earlier this year, the Robert Wood Johnson Foundation's Commission to Build a Healthier America outlined a set of recommendations that include proven measures like smoke-free workplaces and tobacco tax increases.
States should also step up to the plate and fund programs to prevent kids from smoking and help smokers quit at the levels recommended by the Centers for Disease Control and Prevention. It's troubling that no state—not one—currently funds programs at recommended levels, and only nine states fund at even half the CDC's recommendation. Even in the face of budget shortfalls, that is penny wise and pound foolish given that tobacco use costs our nation nearly $100 billion each year in health care bills.
The RWJF Commission also envisioned what all our communities might look like if they were truly "healthy places." This includes encouraging local supermarkets and grocery stores to sell fresh, healthy and affordable foods, so that people can make healthier choices conveniently and close to home. It includes physical education in schools, safer streets, parks and ample green space so that people can be active in their neighborhoods.
What has been glaringly missing in past and present public policy discussions is an understanding that much of what is critical to our health is beyond medical care. But the American people understand that, and they want change.
A poll we released earlier this month together with the Trust for America's Health found that more than three-quarters of Americans support increasing funding for prevention programs. In fact, prevention was rated higher than all other health care proposals, including providing tax credits to small businesses and prohibiting health insurers from denying coverage based on health status. While 77 percent of Americans believe that prevention will save money, an overwhelming majority strongly support prevention regardless of its impact on costs, because they believe it will save lives and prevent disease.
The president placed a down payment on health reform by signing the bill giving the FDA authority over tobacco—a prevention policy that will keep kids from smoking, save lives and reduce health care costs. Congress should build on this accomplishment and ensure that health is the cornerstone of health reform.
Risa Lavizzo-Mourey, a physician, is president and CEO of the Robert Wood Johnson Foundation.